Provider Demographics
NPI:1205100757
Name:WRIGHT, ANDREW JORDAN (PHD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JORDAN
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 W 18TH ST UNIT 1439
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10113-9655
Mailing Address - Country:US
Mailing Address - Phone:347-391-5104
Mailing Address - Fax:
Practice Address - Street 1:217 W 18TH ST # 1439
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4516
Practice Address - Country:US
Practice Address - Phone:347-391-5104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2022-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016869103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical